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How to get CGMS reimbursement

Insurance Carriers Who Cover CGMS

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Has anyone been successful

Has anyone been successful with getting Aetna to cover on their case by case determination? If so, any suggested tactics? Thank you

cgms BCBS insurance NY

New York Blue Cross Blue Shield (PPO) does accept the following codes for Medtronics Insulin Pump Model 722 or 522 with Continuous Blood Glucose Monitor:

Insulin pump Billing Number E 0784--Reservoir Billing Number A4232--, Infusion set Billing number A4231--, Sensors Billing number A9276--, Transmitter A9277--, Alcohol Preps Billing Number A5199

I had my Diabetes doctor give me the diagnosis of "asymptomatic" (without ANY systoms) of hypoglysemic to get the CGMS/insulin pump

Insurance Companies Already Covering CGMS

INSURANCE COMPANIES ALREADY COVERING CGMS:

Anthem BC/BS of Tennessee

Anthem BC/BS of Virginia (on a case-by-case basis)

Blue Cross Blue Shield of Minnesota

Blue Cross Blue Shield of Nebraska (on a case-by-case basis)

Medica

Tricare Prime

United HealthCare (on a case-by-case basis)

Aetna (on a case-by-case basis)

HealthPartners of Minnesota

First Administrators

International Medical Group (per Budapest)

The billing codes for CMGS for these companies are:

A9276 for the sensor

A9277 for the transmitter

A9278 for the receiver

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